As a relatively recently diagnosed T2, I have been puzzled by the apparent disconnect (in some cases) between the patient's and the doctor's approach.
In summary, the doctors may be over-emphasizing the drug approach and under-emphasizing the dietary/exercise/lifestyle approach even though it can help a lot of T2s and even allow some of us to do without any meds at all.
So what may be going on? Bear with me for a minute:
(1) Uncontrolled diabetes is a serious disease with nasty complications. For a doctor to fail to do everything necessary to treat diabetes patients, and thus allow complications to develop, would be hard to understand -- even if that was just a handful of patients out of several hundred. If that means drugs could be over-prescribed in some cases, it is still to the "overall good" of the patient cohort viewed as a whole.
(2) The non-drug approaches to diabetes are entirely reliant on "self treatment." It's all very well for a doctor to give dietary/exercise/lifestyle advice but how many people will follow it? Also, how many will be totally truthful with their doctor when reporting what they have been doing? Plus, once again, it only takes a small percentage of failure to show the doctor in a pretty bad light.
(3) I am quite surprised at how vague the state of diagnostic knowledge seems to be. We all know the broad outline. When looking at T2, the issue can involve insulin resistance and eventually the exhaustion of the pancreas, such that it doesn't produce enough insulin. There are all sorts of tests for glucose tolerance or whatever, but almost no detailed "individual diagnosis." So for instance, I know that I am a Type 2 but have no precise knowledge of the state of health of my pancreas. I know that it must be working reasonably well because the diet/exercise regimen is working great. I have no precise idea how strong the insulin resistance is, nor (precisely) how healthy the pancreas is. These are obvious limits to modern medicine: and they are a powerful incentive for doctors to lump all diabetics into one basket when making treatment decisions.
I have no professional medical knowledge and I may be completely off-base in my analysis above. It's just my "two cents" as they say here in America.